Assessment of Syphilis Screening Following Policy Implementation in an Outpatient Clinic Setting as an Outbreak Response Activity.

CONTEXT: Between 2020 and 2022, the US saw sharp increases in syphilis cases, particularly among American Indian and Alaska Native (AI/AN) people. In July of 2023, the Indian Health Service (IHS), the federal agency charged with providing health care services to AI/AN people, recommended annual syphilis screening for all people aged 13 to 64 years to address the nationwide syphilis outbreak.

OBJECTIVES

To assess annual syphilis screening policy recommendation changes at an outpatient clinical facility in 1 IHS clinical service unit and associated case finding outcomes between May 2022 and May 2025.

DESIGN

A retrospective analysis of medical and public health records related to syphilis screening and positivity as a public health practice activity.

SETTING

An outpatient clinical facility in 1 IHS clinical service unit in South Dakota.

PARTICIPANTS

Any 13- to 64-year-old person who had at least 1 visit to primary care services at the facility. Individuals were eligible for inclusion once for each year analyzed. A total of 27 282 unique visits were analyzed.

INTERVENTION: Implementation of an annual syphilis screening policy for those aged 13 to 64 years.

MAIN OUTCOME MEASURE: Percentage change in syphilis screening coverage.

RESULTS

Syphilis screening coverage increased by 57% overall after policy implementation, including increased coverage among females, males, all age groups, and pregnant people. A total of 354 cases of syphilis were newly diagnosed.

CONCLUSIONS

After implementation of a facility-based annual syphilis screening policy for those aged 13 to 64 years, screening coverage for syphilis increased nearly 60% and over 350 cases of syphilis were identified during a syphilis outbreak in the community. In this outbreak setting, increased screening facilitated case finding and represents an important component of overall outbreak response efforts.